Coronavirus Case Report
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First & Last name of reporting person *
Phone Number *
First & Last name of infected person (if different)
Infected person phone number (if different)
Are there siblings in the household that play for MYSC? *
Name of siblings
Is there a parent in the household that is a MYSC coach? *
Name of parent coach?
Report Date (Today's Date) *
MM
/
DD
/
YYYY
Report Time (Current Time) *
Time
:
Start of symptom(s) (Date) *
MM
/
DD
/
YYYY
Symptom Summary (Check all that apply) *
Required
When was the last time you attended an MYSC event? *
MM
/
DD
/
YYYY
Was a COVID test done? *
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